TY - JOUR
T1 - Helicobacter pylori-negative and non-steroidal anti-inflammatory drugs-negative idiopathic peptic ulcers show refractoriness and high recurrence incidence
T2 - Multicenter follow-up study of peptic ulcers in Japan
AU - Kanno, Takeshi
AU - Iijima, Katsunori
AU - Abe, Yasuhiko
AU - Yagi, Makoto
AU - Asonuma, Sho
AU - Ohyauchi, Motoki
AU - Ito, Hirotaka
AU - Koike, Tomoyuki
AU - Shimosegawa, Toru
N1 - Publisher Copyright:
© 2016 Japan Gastroenterological Endoscopy Society.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Background and Aim: Helicobacter pylori-negative and non-steroidal anti-inflammatory drugs (NSAIDs)-negative idiopathic peptic ulcers (IPU) have attracted attention in Japan and other developed countries. The aim of the present study was to clarify the healing rate of IPU and the risk of recurrence. Methods: We conducted a retrospective follow-up study of patients with peptic ulcer disease (PUD) who were diagnosed in our previous multicenter-prospective study. Three hundred and eighty-two patients from four institutions in the Tohoku district were enrolled. Enrolled subjects were divided into four groups according to H. pylori infection and intake of NSAIDs. In these patients, we checked treatment course, healing rate during 3 months, and recurrence rate. Results: Healing rates in the: (i) simple H. pylori group; (ii) H. pylori (+)/ NSAIDs (+) group, (iii) simple NSAIDs group; and (iv) IPU group, were 95.0%, 94.9%, 73.3%, and 77.4%, respectively. The healing rate of the IPU group was significantly lower than that of both the simple H. pylori group and the H. pylori (+)/ NSAIDs (+) group (P < 0.01). The recurrence rate of 13.9% in the IPU group was much higher than the 2.1% in the simple H. pylori group (P < 0.01). Additionally, the cumulative recurrence rates by the Kaplan–Meier method in the IPU group were significantly higher than those of the simple H. pylori group (P = 0.015). Conclusion: We demonstrated that the clinical course of peptic ulcers is considerably different depending on the cause. IPU could be refractory to treatment and prone to recur compared with simple H. pylori ulcers.
AB - Background and Aim: Helicobacter pylori-negative and non-steroidal anti-inflammatory drugs (NSAIDs)-negative idiopathic peptic ulcers (IPU) have attracted attention in Japan and other developed countries. The aim of the present study was to clarify the healing rate of IPU and the risk of recurrence. Methods: We conducted a retrospective follow-up study of patients with peptic ulcer disease (PUD) who were diagnosed in our previous multicenter-prospective study. Three hundred and eighty-two patients from four institutions in the Tohoku district were enrolled. Enrolled subjects were divided into four groups according to H. pylori infection and intake of NSAIDs. In these patients, we checked treatment course, healing rate during 3 months, and recurrence rate. Results: Healing rates in the: (i) simple H. pylori group; (ii) H. pylori (+)/ NSAIDs (+) group, (iii) simple NSAIDs group; and (iv) IPU group, were 95.0%, 94.9%, 73.3%, and 77.4%, respectively. The healing rate of the IPU group was significantly lower than that of both the simple H. pylori group and the H. pylori (+)/ NSAIDs (+) group (P < 0.01). The recurrence rate of 13.9% in the IPU group was much higher than the 2.1% in the simple H. pylori group (P < 0.01). Additionally, the cumulative recurrence rates by the Kaplan–Meier method in the IPU group were significantly higher than those of the simple H. pylori group (P = 0.015). Conclusion: We demonstrated that the clinical course of peptic ulcers is considerably different depending on the cause. IPU could be refractory to treatment and prone to recur compared with simple H. pylori ulcers.
KW - Helicobacter pylori-negative
KW - Idiopathic peptic ulcer
KW - Non-steroidalantiinflammatory drugs-negative
KW - Recurrence
KW - Refractory
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U2 - 10.1111/den.12635
DO - 10.1111/den.12635
M3 - Article
C2 - 26866510
AN - SCOPUS:84978083178
VL - 28
SP - 556
EP - 563
JO - Digestive Endoscopy
JF - Digestive Endoscopy
SN - 0915-5635
IS - 5
ER -